Radiofrequency Ablation

Radiofrequency Ablation (RFA) is a minimally invasive procedure that uses controlled heat generated by radiofrequency energy to interrupt pain signals carried by specific nerves. It does not involve major surgery and is performed using a specialised needle placed under X-ray guidance.

The goal is to reduce pain while preserving normal movement and function.

Radiofrequency Ablation, commonly referred to as RFA, is a treatment method that leverages the power of radiofrequency energy to combat chronic pain.

Whether it’s neck, lower back, shoulder, hip, knee or sacroiliac joint pain, radiofrequency ablation could be the answer you’ve been searching for.

About Radiofrequency Ablation

Radiofrequency Ablation is a procedure that uses heat generated from radio waves to disrupt pain signals. Through a specialised needle, radiofrequency energy is transmitted to the targeted nerve tissue, creating a heat lesion that impairs the nerve’s ability to send pain signals to the brain, thereby alleviating the patient’s discomfort.

Radiofrequency Ablation has proven to be incredibly effective for managing various types of chronic pain. Some of the most common applications include:

Neck Pain: Chronic pain in the cervical facet joints.
Low Back Pain: Pain in the lumbar facet joints or discogenic pain resulting from herniated or torn discs.
Sacroiliac Joint Pain: Pain arising from the sacroiliac joint due to arthritis or inflammation.

One of the RFA techniques currently available is COOLIEF™. This technique utilises a proprietary cooling mechanism to prevent overheating at the needle tip, allowing for the creation of large-volume, spherical lesions that can treat the nerves causing pain. As a result, COOLIEF™ is often more effective than conventional RFA techniques.

Dr. Ho Kok Yuen is the first doctor in Asia to perform COOLIEF™. Using this technique, he has successfully treated patients with spine, hip, knee, shoulder, back, and neck pain since 2006. Over the past 15 years, he has also trained hundreds of doctors in Singapore, South Korea, Taiwan, Australia, Southeast Asia, and the Middle East in performing COOLIEF™.

Radiofrequency Ablation is a minimally invasive procedure, and it involves the following steps:

Preparation Before the Radiofrequency Ablation

Before your Radiofrequency Ablation treatment, you will need to take a few steps to prepare:

Arrange for Transport: As you will not be able to drive or operate machinery for at least 24 hours after the procedure, arrange for someone to drive you home.
Fasting: Do not eat or drink 6 hours before your procedure, except for a small amount of water to take any necessary medications.
Medication: Inform your doctor about all medications you are currently taking, especially blood thinners or antiplatelet medications, which may need to be temporarily stopped. If you have diabetes and use insulin, consult your doctor about adjusting your dosage.

What Happens in the Actual Radiofrequency Ablation Procedure?

The Radiofrequency Ablation procedure is typically carried out in an operating theatre and takes around 60-90 minutes. You can expect the following:

Sedation: A mild sedative is administered to ensure comfort.
Anaesthesia: Local anaesthetic will be injected at the treatment site to numb the area.
Needle Insertion: A needle is carefully positioned using imaging guidance, such as X-ray.
Radiofrequency Waves: Radiofrequency waves are transmitted through the needle, creating heat that disrupts the nerve’s ability to send pain signals.

Radiofrequency Ablation is generally safe and well-tolerated. However, similar to other procedures like annuloplasty treatment and hip joint injection, there are potential side effects and risks. Some of these include:

During the Procedure: You will likely feel numbness at the injection site due to the local anaesthetic, and you might also temporarily experience a warm or burning sensation as the radiofrequency energy is applied.
After the Procedure: Common side effects include mild back discomfort or soreness at the injection site, which usually subsides within a few days. Some patients might notice numbness or tingling for a few hours post-procedure, and occasionally, bruising or swelling may occur, which can be managed with ice application.
Other Potential Risks: Infection, nerve damage, and allergic reactions to medications are uncommon outcomes of Radiofrequency Ablation.

Most patients recover quickly from Radiofrequency Ablation, and they usually return to their normal activities within a few days. However, it may take a few weeks to experience the full pain-relieving effects of the procedure. To optimise recovery, consider:

Rest: Take it easy for the first 24-48 hours after the procedure, and avoid strenuous activities, heavy lifting, and driving.
Wound Care: Keep the injection site clean and dry, avoiding baths or hot tubs for a day or two.
Pain Management: Manage any mild pain or discomfort with over-the-counter pain medication or apply an ice pack to the area for 15-20 minutes at a time. Avoid using heat packs.

Explore Other Advanced Pain Therapies

Disc Decompression Therapy

Sympathetic Blocks or Neurolysis

Frequently Asked Questions About Radiofrequency Ablation

What is Radiofrequency Ablation (RFA)?

Radiofrequency Ablation (RFA) is a minimally invasive procedure that uses controlled heat generated by radiofrequency energy to interrupt pain signals carried by specific nerves. It does not involve major surgery and is performed using a specialised needle placed under X-ray guidance. The goal is to reduce pain while preserving normal movement and function.

What conditions can Radiofrequency Ablation treat?

RFA can be highly effective for selected pain conditions, including:

Spinal pain caused by painful facet joints in the neck, upper back or lower back.
Trigeminal neuralgia, a severe facial pain caused by irritation of the trigeminal nerve.
Neuropathic pain, such as Complex Regional Pain Syndrome (CRPS), by targeting part of the sympathetic nervous system (sympathetic neurolysis).
Persistent cancer pain affecting the chest, abdomen or pelvic region.

Is Radiofrequency Ablation permanent?

No. The treated nerve is not permanently destroyed. Over time, it can regenerate, and pain may gradually return.

Most patients experience pain relief for 6 to 18 months, although this varies depending on the condition and the individual. If the pain returns and the initial treatment was successful, the procedure can often be safely repeated.

Is the procedure painful, and what is recovery like?

The procedure is usually performed under local anaesthesia, with light sedation if needed. Most patients experience only mild discomfort during the procedure.

After treatment, it is common to have some soreness for a few days. Most patients can return home on the same day and resume light activities within 24 to 48 hours. Improvement in pain may occur immediately or develop gradually over several weeks.

Is Radiofrequency Ablation safe?

RFA has been performed safely worldwide for many years and has an excellent safety record when carried out by experienced pain specialists using image guidance.

As with any medical procedure, there are potential risks, including temporary soreness, bruising, numbness, infection or bleeding. Serious complications are uncommon. Before recommending RFA, your pain specialist will discuss the potential benefits, risks and alternatives, and determine whether you are a suitable candidate.

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